Blood test, clotting time (PTT)

For the CPT code 85730, representing a blood test for clotting time (PTT), Mercy Hospital Pittsburg, Inc. lists a cash median price of $77.00, which is notably lower than the facility's negotiated rates of $92.00 and the gross charge of $118.00. While the facility's negotiated rates fall within the range of $5 to $103 across various payers, the cash price offers a distinct advantage for patients with high-deductible plans or those seeking immediate payment, as it bypasses the administrative overhead and contract structures that typically inflate insurance allowed amounts. Patients should verify their specific plan's negotiated rate before scheduling, as some commercial carriers may pay significantly more than the cash price, making the self-pay option the most cost-effective choice in this instance.

It is important to note that Medicare, which serves as a benchmark for fair pricing, allows a payment of $6.01 for this service, a figure that is substantially lower than both the cash and negotiated rates. Although the facility is a voluntary non-profit church-owned acute care hospital in Pittsburg, KS, the disparity between the Medicare rate and commercial charges highlights the potential for significant cost savings through direct payment or prompt-pay discounts. To minimize out-of-pocket expenses, patients are encouraged to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% when paid in full upfront, effectively bypassing the higher administrative costs associated with insurance billing cycles.